Intra-capsular total thyroid enucleation versus total thyroidectomy in treatment of benign multinodular goiter. A prospective randomized controlled clinical trial

Sewefy, Alaa M.; Tohamy, Tohamy A; Esmael, Tarek M.; Atyia, Ahmed M.

doi:10.1016/j.ijsu.2017.07.074

Cited by 8 publications

(4 citation statements)

References 24 publications

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“…However, the possibility of recurrence and the need for a completion thyroidectomy if the final histology is cancer, are important considerations. For these reasons, the 2016 guidelines and meta-analysis recommended total thyroidectomy for both toxic and non-toxic benign multinodular goiter [58,59]. Total thyroidectomy can now be performed as safely as lobectomy and subtotal thyroidectomy are performed, because of improved surgical techniques and experience [50,60].…”

Section: Discussionmentioning

confidence: 99%

Retrospective Study on the Incidence of Thyroid Disorders in Bisha and Evolving Surgical Management Considerations

Bawa¹,

Khan²,

Khalifa³

et al. 2021

Int J Surg Res Pract

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Background: There is a high prevalence of goiter in Bisha despite more than 15 years of the national campaign for increased dietary iodine supplementation. The cause is multifactorial. It is associated with non-neoplastic and neoplastic conditions. Surgical management has evolved over many years.Purpose: To describe the pathological types of goiter in Bisha along with their management and to discuss current surgical considerations. Methodology:A retrospective review of 339 patients with goiter diagnosed by FNAC and or histopathological examination and managed surgically or non-surgically.Results: There were 339 patients, of which 280 (82.6%) were females and 59 (17.4%) males. Age range was seven to 94 years with a mean of 39.18 ± 13.87 years. There were 138 (40.7%) multinodular goiters, 82 (24.2%) colloid goiters, 8 diffuse goiters (2.4%), 40 (11%) solitary thyroid nodules, 10 thyroid nodules (2.9%), 14 thyroid cysts (4.1%), 20 Hashimoto's thyroiditis (5.9%) and two de Quervain's thyroiditis (0.6%). Benign thyroid neoplasms comprised of 25 (7.4%) follicular adenomas and 11 (3.2%) Hürthle cell adenomas. Malignant thyroid disorders consisted of 18 (5.3%) papillary thyroid cancers, 7 (2.1%) mixed papillary/ follicular thyroid cancers, one (0.3%) mixed follicular/ papillary thyroid cancer, and three (0.9%) follicular thyroid cancers respectively. There were 128 (37.1%) total thyroidectomies, 70 (20.6%) hemithyroidectomies, 10 (2.9%) subtotal thyroidectomies and, 5 (1.5%) near-total thyroidectomies. There were 125 (36.9%) patients who had no surgery. The overall complication rate was 14.5%. Conclusion:Thyroid disorders are still prevalent despite years of dietary iodine supplementation campaigns. The rate of complications following total thyroidectomy is significant and guidelines are changing.

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Section: Discussionmentioning

confidence: 99%

Retrospective Study on the Incidence of Thyroid Disorders in Bisha and Evolving Surgical Management Considerations

Bawa¹,

Khan²,

Khalifa³

et al. 2021

Int J Surg Res Pract

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“…Sewefy et al made study on 224 patients 112 patients underwent intracapsular total thyroidectomy and 112 patients underwent extracapsular total thyroidectomy and found that by intracapsular method the complication of recurrent laryngeal nerve injury was 0% compared to 0.9% in extracapsular method and permanent hypocalcaemia was 0% in intracapsular method compared to 0.9% in extracapsular method. 11 Meer et al made retrospective study on patients on tertiary care center and complications was counted from this technique and found that 0% cases complicated from permanent recurrent laryngeal nerve damage and temporary neuropraxia was around 0.5% and The incidence of temporary and permanent hypocalcaemia was found to be around 0.7% and 0.2% respectively. 12 Dong y et al made retrospective study on 44 patients underwent thyroid capsular dissection and the result was 1 patient suffered from postoperative hoarseness of voice.…”

Section: Discussionmentioning

confidence: 99%

“…14 All of these studies suggest that the new technique is easy to learn and do by junior surgeons which make it perfect choice in secondary health centres like central hospital in which study was made because the previous studies was done only in highly specialized centres like universities hospitals or endocrine surgery centres only. 11 In the new technique time in searching for recurrent laryngeal is saved as in intracapsular dissection no time spent in searching for recurrent laryngeal nerve or parathyroid glands. 14…”

Section: Discussionmentioning

confidence: 99%

Evaluation of intracapsular total thyroidectomy as a safe method in benign thyroid diseases

et al. 2019

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Background: Intracapsular total thyroidectomy is a rising new technique in management of benign thyroid disease seeking for safety. Our aim in this study is to evaluate safety and effectiveness of intracapsular technique in treatment of benign thyroid disease.Methods: this prospective study was carried out in department of general surgery, Menoufia University hospital and department of general surgery, Tala central hospital; from June 2018 to April 2019 on 58 patients with benign thyroid disease all had undergone intracapsular total thyroidectomy.Results: 58 patients underwent intracapsular total thyroidectomy. There was no recurrent laryngeal nerve injury either transient or permanent and no external laryngeal nerve injury. There was no parathyroid injury or hypoparathyriod complications.Conclusions: Intracapsular total thyroidectomy is a safe method in treatment of benign thyroid disease and can be done easily in central hospitals and non-highly specialized centres.

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“…None of the studies got the highest stars i.e., 9 and all observational studies remained between five and three stars. One randomized control trial by Sewefy et al 21 was analyzed by the Cochrane Risk of Bias tool for randomized studies 25 and had a high risk of bias as the blinding of participants and personnel was not specified (performance bias).…”

Section: Methodsmentioning

confidence: 99%

Incidence Of Hypoparathyroidism After Total Thyroidectomy for Benign Goitres. A Systematic Review

Ghani¹,

Haq²,

Rehman³

et al. 2023

JRMC

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Objective: systematic review assessed the overall incidence of hypoparathyroidism after Total thyroidectomy (TT) for benign goitres. Methods: A systematic search of PubMed, google scholar, Cochrane, and Pakmedinet under PRISMA (preferred reporting items for systematic reviews and Meta-analyses) guidelines was performed. All studies during the last 50 years where TT was performed for benign goitres and post-operative hypoparathyroidism was assessed were included. The total incidence of both transient and permanent hypoparathyroidism was calculated after TT for benign goitres. The risk of bias was also assessed. Results: Twelve studies were included in total including eight retrospective, three prospective observational studies, and one randomized trial. Three studies were from Turkey, 2 from Pakistan, 2 from Greece, and one each from Saudi Arabia, India, Denmark, Egypt, and the USA. 2809 TT were performed for benign goitres. Overall Transient hypoparathyroidism (THP) was noted in 290 (10%) patients while permanent hypoparathyroidism (PHP) was noted in 33(1.17%) patients. The highest incidence of permanent hypoparathyroidism was 17% in one study while the lowest was 0% in three studies. The highest incidence of transient hypoparathyroidism was 28.5% in one study while the lowest incidence was 2.5%. The risk of bias was high. Conclusion: TT for benign goitres is associated with 1.17 % overall risk (range 0%-17%) of PHP and 10% (range 2.5%-28.5%) of THP.

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Intra-capsular total thyroid enucleation versus total thyroidectomy in treatment of benign multinodular goiter. A prospective randomized controlled clinical trial

Abstract: Intracapsular Total thyroid enucleation technique is safe with the least serious complications, especially RLN injury and hypoparathyroidism, with no recurrence, but this technique still not radical so couldn't be used in suspicious cases for malignancy.

Cited by 8 publications

References 24 publications

Retrospective Study on the Incidence of Thyroid Disorders in Bisha and Evolving Surgical Management Considerations

Retrospective Study on the Incidence of Thyroid Disorders in Bisha and Evolving Surgical Management Considerations

Evaluation of intracapsular total thyroidectomy as a safe method in benign thyroid diseases

Incidence Of Hypoparathyroidism After Total Thyroidectomy for Benign Goitres. A Systematic Review

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